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Denied Insurance Claim Options
Summary
If your homeowners insurance claim is denied due to normal wear and tear, you can file a complaint with the New York State Department of Financial Services. Ensure you provide all necessary documents and details. If the issue remains unresolved, consider representing yourself in court. Familiarize yourself with the New York Civil Practice Law and Rules (CPLR) for a smoother process.Full Conversation
I had a ceiling in my living room collapse and my home owners insurance is denying the claim.
Hello ****, I'm sorry to hear about your situation. Denial of insurance claims can be based on various reasons. In New York, some common reasons include:
- Non-payment of premium
- Damage not covered in the policy
- The claim exceeds the policy limit
Do you know the specific reason for your claim denial?
- Non-payment of premium
- Damage not covered in the policy
- The claim exceeds the policy limit
Do you know the specific reason for your claim denial?
They are stating "normal wear and tear" which is not covered. They based this only on photos I provided. They did not send anyone out to investigate. My policy is for all perils. I will provide copies of all emails in a moment
I'm sorry to hear about your situation, ****. In New York, insurance companies must conduct a "reasonable investigation" before denying a claim. If you believe they failed to do so, you might have grounds for a complaint. Here's what you can do:
- Request a written explanation for the denial.
- File a complaint with the New York State Department of Financial Services.
- Consider seeking legal counsel for further assistance.
- Request a written explanation for the denial.
- File a complaint with the New York State Department of Financial Services.
- Consider seeking legal counsel for further assistance.
I have had conversations with several lawyers. They all seem to think i have a case but will not get involved because the case is too small and is therefore not worth their time. They recommend I proceed pro se. Can you help with that?
Absolutely ****, I can guide you through the general process of representing yourself, or "pro se". Here are some steps to follow:
*. File the complaint: You'll need to draft and file a complaint outlining your claims.
*. Discovery: Collect and exchange evidence with the other party.
*. Pretrial: Prepare and file pretrial motions.
*. Trial: Present your case before a judge or jury.
Remember, each step has specific rules and procedures. It would be beneficial to familiarize yourself with the New York Civil Practice Law and Rules (CPLR).
*. File the complaint: You'll need to draft and file a complaint outlining your claims.
*. Discovery: Collect and exchange evidence with the other party.
*. Pretrial: Prepare and file pretrial motions.
*. Trial: Present your case before a judge or jury.
Remember, each step has specific rules and procedures. It would be beneficial to familiarize yourself with the New York Civil Practice Law and Rules (CPLR).
would it be advisable to first file a complaint with the department of financial services?
Yes, it is generally advisable to first file a complaint with the New York State Department of Financial Services. This can help resolve the issue without going to court and may provide useful evidence if you later decide to sue.
can you give me step by step instructions and tell me what to include in in the complaint?
Sure, here are general steps and elements to include in your complaint:
*. **Identify Parties**: State your name as the plaintiff and the insurance company as the defendant.
*. **Jurisdiction**: Explain why the court has authority.
*. **Facts**: Detail the events leading to the claim denial.
*. **Claim**: State how the defendant's actions are unlawful.
*. **Relief**: Specify what you want the court to do (e.g., pay damages).
*. **Signature**: Sign and date the complaint.
Remember, this process can be complex. Consider seeking help from a legal aid service.
*. **Identify Parties**: State your name as the plaintiff and the insurance company as the defendant.
*. **Jurisdiction**: Explain why the court has authority.
*. **Facts**: Detail the events leading to the claim denial.
*. **Claim**: State how the defendant's actions are unlawful.
*. **Relief**: Specify what you want the court to do (e.g., pay damages).
*. **Signature**: Sign and date the complaint.
Remember, this process can be complex. Consider seeking help from a legal aid service.
Sorry, i meant the complaint with the NYS Dept of Financial Services
Sure, here's how to file a complaint with the NYS Department of Financial Services:
*. **Go online**: Visit the DFS portal.
*. **Select 'File a Complaint'**: Choose the relevant insurance type.
*. **Fill out the form**: Provide all the requested details.
*. **Explain your issue**: Detail your denied claim and reasons given by the insurer.
*. **Attach documents**: Include all relevant documents like policy, denial letters, etc.
*. **Submit**: Follow the prompts to submit.
Remember to keep a copy of your complaint for your records.
*. **Go online**: Visit the DFS portal.
*. **Select 'File a Complaint'**: Choose the relevant insurance type.
*. **Fill out the form**: Provide all the requested details.
*. **Explain your issue**: Detail your denied claim and reasons given by the insurer.
*. **Attach documents**: Include all relevant documents like policy, denial letters, etc.
*. **Submit**: Follow the prompts to submit.
Remember to keep a copy of your complaint for your records.
can i mark my place here and save this conversation
Yes, you can certainly save this conversation for future reference. However, the exact method to do so depends on the platform you're using. Usually, you can bookmark the page or take screenshots.
I know you are not human. Do you appreciate a Thank you on any level?
As an artificial intelligence, I don't have feelings or emotions. However, I'm programmed to assist you to the best of my abilities and your feedback helps improve my service. So, in that sense, a "Thank You" is always appreciated.
Thank you
You're welcome, ****! If you have any more questions or need further assistance in the future, please don't hesitate to ask. Good luck with your complaint process!
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